Albumin as a prognostic marker for ulcerative colitis

作者：Khan Nabeel^*; Patel Dhruvan; Shah Yash; Trivedi Chinmay; Yang Yu Xiao

来源：World Journal of Gastroenterology, 2017, 23(45): 8008-8016.

DOI：10.3748/wjg.v23.i45.8008

• Prognostic marker
• Albumin
• Ulcerative colitis
• Disease course
• Colectomy

AIM
To evaluate the role of albumin at the time of ulcerative colitis (UC) diagnosis in predicting the clinical course of disease.
METHODS
Nationwide cohort of patients with newly diagnosed UC in the Veterans Affairs health care system was identified and divided into two categories: hypoalbuminemia (i.e., = 3.5 gm/dl) or normal albumin levels (i.e., > 3.5 gm/dl) at the time of UC diagnosis. The exposure of interest was presence of hypoalbuminemia defined as albumin level = 3.5 g/dl at the time of UC diagnosis. Patients were then followed over time to identify the use of = 2 courses of corticosteroids (CS), thiopurines, anti-TNF medications and requirement of colectomy for UC management.
RESULTS
The eligible study cohort included 802 patients, but 92 (11.4%) patients did not have their albumin levels checked at the time of UC diagnosis, and they were excluded. A total of 710 patients, who had albumin levels checked at time of UC diagnosis, were included in our study. Amongst them, 536 patients had a normal albumin level and 174 patients had hypoalbuminemia. Patients with hypoalbuminemia at diagnosis had a higher likelihood of = 2 courses of CS use (adjusted HR = 1.7, 95% CI: 1.3-2.3), higher likelihood of thiopurine or anti-TNF use (adjusted HR = 1.72, 95% CI: 1.23-2.40) than patients with normal albumin level at diagnosis. There was a trend of higher likelihood of colectomy in hypoalbuminemic patients, but it was not statistically significant (Adjusted HR = 1.7, 95% CI: 0.90-3.25).
CONCLUSION
Hypoalbuminemia at disease diagnosis can serve as a prognostic marker to predict the clinical course of UC at the time of diagnosis.

• 出版日期2017-12-7